Women's Health Clinic (Singapore)

Screening for a vaginal infection is recommended if you have symptoms suggestive of one (see below), or if you feel well but fall into any of the following categories:

• You have had recent unprotected sexual exposure with a new partner whose infection status is unknown
• Your partner has been diagnosed with STD (Sexually Transmitted Disease) e.g. chlamydia/gonorrhoea
• You are planning to conceive, as infections may complicate pregnancy and should ideally be treated prior to conception

Vaginal infections can be caused by bacteria, viruses, fungi or parasites (protozoa). Not all are sexually transmitted and some may occur due to disruption of the normal vaginal flora.

A basic physical examination including a speculum examination will be performed. This often confirms the presence of abnormal discharge and may reveal signs of inflammation.

A high vaginal swab or endocervical swab (taken during the speculum examination) is needed to confirm the specific infection as the appearance of discharge alone is not specific enough, and a few infections may often coexist.

The treatment of vaginal infections may come in the form of oral antibiotics or antifungal medications and/or topical creams or pessaries. The specific choice of therapy depends on the causative organism.

For sexually transmitted infections, treatment should extend to include your sexual partner so as to avoid recurrent transmission and reinfection between partners. Abstinence from intercourse is advisable during the treatment period. A repeat swab test performed 2-3 weeks after completion of the course of medication may sometimes be necessary to confirm successful treatment.

Certain sexually transmitted infections e.g. chlamydia and gonorrhoea, if left untreated, may spread upwards to affect the uterus (womb), fallopian tubes and ovaries, resulting in a condition called pelvic inflammatory disease, which may, in turn, lead to scarring and potential infertility.

Some common recurrent vaginal infections include yeast (candida) infections and bacterial vaginosis. Sexually Transmitted Infections (STIs) may also recur if not fully treated.

The identification of triggers such as sexual intercourse and the use of over-the-counter feminine douches may be useful in reducing yeast infections and bacterial vaginosis.

For sexually transmitted infections, the correct use of condoms/barrier protection, as well as limiting the number of sexual partners reduces the risk of transmission and recurrent infections.